RT 12 (Ch. 10) Ribs, Sternum, SC Joints

The suprasternal, manubrial, or jugular notch all correspond to the level of:

T 2-3

The Xiphoid process corresponds to the vertebral level of:

T9-10

What is the primary term for the superior margn of the sternum?

Jugular Notch

At approximately what age does the xiphoid process become totally ossified?

40 years old

Which of the following structures connects the anterior aspect of the rigs to the sternum?

Costocartilage

(True or False) The tubercle portion of a typical rib connects the anterior end of the rib to the sternum.

False

(True or False) The only bony connection between the shoulder girdle and the bony thorax is the acromioclavicular joint.

False

The sternal angle is a palpable landmark at the level of:

T4-5

Which pair of ribs attaches to the sternum at the level of the sternal angle?

Second

In the erect adult bony thorax, the posterior portion of a typical rib is ____ higher or more superior to the anterior portion.

3-5 inches (7.5 to 13 cm)

Which of the following ribs is considered to be a false rib?

Ninth

How do floating ribs differ?

They do not possess costocartilage

The widest aspect of the thorax generally occurs at the level of:

The 8-9th ribs

What is the joint classification and type of movement for the sternoclavicular joints?

Synovial with diarthrodial (gliding) movement

Which aspect of the rib articulates with the thoracic vertebral body?

Head

Which ribs are considered to be true ribs?

1st-7th ribs

(True or False) The degree of rotation for the RAO projection of the sternum is dependent on the size of the thoracic cavity.

True

What is most effective in preventing lung markings from obscuring the sternum on an oblique projection?

Orthostatic breathing technique

Why is the RAO sternum preferred to the LAO position?

Rao projects the sternum over the shadow of the heart

What is the breathing technique for radiography of ribs located above the diaphragm?

Suspended inspiration

Which of the following positions will best demonstrate the axillary portion of the left ribs?

LPO

Which of the following positions will best demonstrate the axillary portion of the Right Ribs?

LAO

The recommended practice is to decrease the SID to less than 40 inches for the oblique sternum projection to increase the magnification and resultant unsharpness of overlying ribs.

False

Which of the following conditions may occur with trauma to the ribs?

Hemothorax

What is the recommended degree of obliquity for an RAO projection of the sternum for an asthenic type of patient?

20 Degrees

Which position can replace the RAO of the sternum if the patient cannot lie prone?

LPO

What is the recommended SID for the lateral sternum positon?

60-72 inches

Where is the CR centered for a PA projection of the sternoclavicular joints?

3 inches distal to vertebra prominence (T2-3)

How much rotation and which oblique position are required to best demonstrate the left sternoclavicular joints?

10-15 degree LAO

Which two projections must be taken for an injury to the right anterior upper ribs?

PA and LAO

Which two projections must be taken for an injury to the left posterior lower ribs?

AP and LPO

Fracture of adjacent ribs in two or more places with associated pulmonary injury is known as a(n) ___ rib fracture.

Flail Chest

The radiographic appearance of the erosion of bony rib margins is a possible indication of:

osteomyelitis

A congential defect characterized by anterior protrusion of the lower sternum and xiphoid process is termed:

Pectus Carinatum

Which condition of the sternum is often termed "funnel chest?"

Pectus excavatum

The condition, flail chest, is most connomly caused by?

Blunt Trauma

A radiograph of an RAO sternum reveals that it is partially superimposed over the spine. What must be done to eliminate this problem during the repeat exposure?

Increase rotation of the body

A radiograph of a lateral projection of the sternum reveals that the patient's ribs are superimposed over the sternum. What needs to be done to correct this problem during the repeat exposure?

Ensure that the patient is not rotated

A radiograph of an RAO projection of the sternum demonstrates excessive lung markings obscuring the sternum. A 1-second exposure time and an orthostatic breathing technique were used. Which of the following will produce a more diagnostic image of the sternum?

Increase the exposure time; decrease the mA

A PA radiograph of the SC joints demonstrates unequal distance from the SC joints to the midline of the spine. The left SC joint is farther from the sternum than the right. What specific positioning error is present on this radiograph?

Slight right rotation (right side toward the IR)

A young female patient from the emergency department is brought to radiology for rib examination. She is able to sit up or stand for the procedure. She indicates that the region of pain is to the right anterior-to-mid axillary region. Which rib projections should be performed to minimize the effective dose to this patient?

PA and LAO

A patient enters the ED with an injury to the left anterior ribs. Which of the following projections should be taken to demonstrate the involved area?

PA and RAO

An ambulatory patient enters the ED with a possible injury to the right upper posterior ribs. Which of the following routines should be taken to demonstrate the involved area?

Erect AP and RPO

A patient enters the ED with blunt trauma to the sternum. The patient is in great pain and cannot lie prone on the table or stand erect. Which of the following routines would best be best for the sternum examination in this situation?

LPO and horizontal beam lateral projections

A patient enters the ED with trauma to the bony thorax. The initial radiographs reveal that there are fractured ribs and a possible pneumothorax of the left thorax. The physician orders a chest study to confirm the pneumothorax; however, the patient cannot stand. Which of the following positions would best demonstrate the pneumothorax?

Right lateral decubitus

What is the minimum number of ribs that must be demonstrated for a unilateral rib study above the diaphragm?

Ribs 1-10

(True or False) A lateral projection of the sternum requires that respiration be suspended on expiration.

False

A radiograph of an RAO projection of the ribs demonstrates the left acillary ribs are foreshortened, whereas the right side is elongated. Which of the following is the most likely reason for this radiographic outcome?

An LAO was performed rather than the RAO positon

A patient with metastatic disease in the ribs comes to radiology following a nuclear medicine scan. The radiologist orders a right, upper posterior rib study performed. Which of the following positioning factors should be followed for this specific study?

Perform positions erect if patient condition permits and include the RPO positon as part of the positioning routine

Which of the following positioning considerations does NOT apply for a study of the lower ribs?

Use a digital kV range between 65-70 kV.